Investig Clin Urol.  2018 Nov;59(6):376-382. 10.4111/icu.2018.59.6.376.

Renal function is associated with prognosis in stent-change therapy for malignant ureteral obstruction

Affiliations
  • 1Department of Urology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. tmkwon@uuh.ulsan.kr

Abstract

PURPOSE
The authors performed this study to investigate the risk factors for predicting stent failure and to evaluate its impact on prognosis.
MATERIALS AND METHODS
Between January 2002 and March 2017, we retrospectively reviewed 117 consecutive patients who underwent retrograde ureteral stenting and exchanging at least once every 3 months for malignant ureteral obstruction. The patients were classified according to their pre-stenting chronic kidney disease (CKD) stage. The factors affecting stent failure were analyzed using a logistic regression model. Overall survival (OS) was estimated, and the prognostic significance of each variable was estimated using Cox proportional-hazards regression modeling.
RESULTS
Before stenting, 91 patients were CKD stages 1-3 and 26 patients were CKD stages 4-5. These two groups differed significantly only in pre-stenting estimated glomerular filtration rate (eGFR), bilateral obstruction, and pre-stenting pyuria. Among the 117 patients, stent failure occurred in 30 patients (25.6%), and there were no differences between the groups. Pre-stenting pyuria and post-stenting complications were significant predictors of stent failure. There were 79 deaths in total, including 56 in the CKD stages 1-3 group and 23 in the CKD stages 4-5 group. In the multivariate analysis predicting patient OS, pre-stenting eGFR and post-stenting disease progression were significant factors.
CONCLUSIONS
Internal ureteral stenting was effective for maintaining renal function in malignant ureteral obstruction. However, it did not restore renal function, which is related to the prognosis of the patients. Therefore, to improve patients' renal function and prognosis, patients who require stenting must be quickly recognized and treated.

Keyword

Kidney; Prognosis; Stent; Ureteral obstruction

MeSH Terms

Disease Progression
Glomerular Filtration Rate
Humans
Kidney
Logistic Models
Multivariate Analysis
Prognosis*
Pyuria
Renal Insufficiency, Chronic
Retrospective Studies
Risk Factors
Stents
Ureter*
Ureteral Obstruction*
Full Text Links
  • ICU
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error